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Distribution and risk factors of postoperative endophthalmitis in people with diabetes

PURPOSE: To evaluate (i) the distribution of postoperative endophthalmitis (POE) in patients who underwent cataract surgery, (ii) risk factors in diabetic versus nondiabetic patients, and (iii) distribution of POE in those who had undergone rapid reduction of preoperative blood sugar levels versus t...

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Autores principales: Gondhale, Harshal, Jaichandran, VV, Jambulingam, Malathi, Anand, Appakkudal R, Srinivasan, Sangeetha, Raman, Rajiv, Sharma, Tarun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725099/
https://www.ncbi.nlm.nih.gov/pubmed/34708798
http://dx.doi.org/10.4103/ijo.IJO_1485_21
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author Gondhale, Harshal
Jaichandran, VV
Jambulingam, Malathi
Anand, Appakkudal R
Srinivasan, Sangeetha
Raman, Rajiv
Sharma, Tarun
author_facet Gondhale, Harshal
Jaichandran, VV
Jambulingam, Malathi
Anand, Appakkudal R
Srinivasan, Sangeetha
Raman, Rajiv
Sharma, Tarun
author_sort Gondhale, Harshal
collection PubMed
description PURPOSE: To evaluate (i) the distribution of postoperative endophthalmitis (POE) in patients who underwent cataract surgery, (ii) risk factors in diabetic versus nondiabetic patients, and (iii) distribution of POE in those who had undergone rapid reduction of preoperative blood sugar levels versus those with normal blood sugar levels. METHODS: Medical records were reviewed from January 1995 to July 2021. In total, 391 eyes of 391 patients who developed POE after cataract surgery were studied. Patients with POE were divided into Group A, patients with diabetes (n = 128), and Group B, patients without diabetes (n = 263), and the associations of various clinical factors in the two groups were studied. Patients with diabetes with raised random blood sugars (RBS) preoperatively were subjected to a rapid reduction of blood sugar (RBS <200 mg%) to be considered eligible for surgery. Microbiological profile of patients was examined. RESULTS: The cumulative incidence of POE over 26 years was 0.09%. Those who underwent a rapid reduction in preoperative blood sugar levels had higher rates of POE (53.1%) compared with (46.9%) those with blood sugar levels under control (P = 0.486). Men with diabetes had 1.634 times higher odds of POE (P = 0.048), and those with diabetes and hypertension had 3.961 times greater odds of having POE (P < 0.001) when adjusted for age, alcohol, smoking, and socioeconomic strata and presence of posterior capsule rupture. Positive culture results were observed in 45/128 (35%) patients with diabetes and 71/263 (27%) patients without diabetes. Staphylococcus epidermidis was the most commonly identified organism and was detected in 10/45 (22%) in those with diabetes and 21/71 (29%) in those without diabetes of all the culture-positive cases. CONCLUSION: In patients with POE, the odds are greater for men with diabetes, those with a history of hypertension, as well as those who undergo a rapid reduction of preoperative blood sugar.
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spelling pubmed-87250992022-01-20 Distribution and risk factors of postoperative endophthalmitis in people with diabetes Gondhale, Harshal Jaichandran, VV Jambulingam, Malathi Anand, Appakkudal R Srinivasan, Sangeetha Raman, Rajiv Sharma, Tarun Indian J Ophthalmol Original Article PURPOSE: To evaluate (i) the distribution of postoperative endophthalmitis (POE) in patients who underwent cataract surgery, (ii) risk factors in diabetic versus nondiabetic patients, and (iii) distribution of POE in those who had undergone rapid reduction of preoperative blood sugar levels versus those with normal blood sugar levels. METHODS: Medical records were reviewed from January 1995 to July 2021. In total, 391 eyes of 391 patients who developed POE after cataract surgery were studied. Patients with POE were divided into Group A, patients with diabetes (n = 128), and Group B, patients without diabetes (n = 263), and the associations of various clinical factors in the two groups were studied. Patients with diabetes with raised random blood sugars (RBS) preoperatively were subjected to a rapid reduction of blood sugar (RBS <200 mg%) to be considered eligible for surgery. Microbiological profile of patients was examined. RESULTS: The cumulative incidence of POE over 26 years was 0.09%. Those who underwent a rapid reduction in preoperative blood sugar levels had higher rates of POE (53.1%) compared with (46.9%) those with blood sugar levels under control (P = 0.486). Men with diabetes had 1.634 times higher odds of POE (P = 0.048), and those with diabetes and hypertension had 3.961 times greater odds of having POE (P < 0.001) when adjusted for age, alcohol, smoking, and socioeconomic strata and presence of posterior capsule rupture. Positive culture results were observed in 45/128 (35%) patients with diabetes and 71/263 (27%) patients without diabetes. Staphylococcus epidermidis was the most commonly identified organism and was detected in 10/45 (22%) in those with diabetes and 21/71 (29%) in those without diabetes of all the culture-positive cases. CONCLUSION: In patients with POE, the odds are greater for men with diabetes, those with a history of hypertension, as well as those who undergo a rapid reduction of preoperative blood sugar. Wolters Kluwer - Medknow 2021-11 2021-10-29 /pmc/articles/PMC8725099/ /pubmed/34708798 http://dx.doi.org/10.4103/ijo.IJO_1485_21 Text en Copyright: © 2021 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Gondhale, Harshal
Jaichandran, VV
Jambulingam, Malathi
Anand, Appakkudal R
Srinivasan, Sangeetha
Raman, Rajiv
Sharma, Tarun
Distribution and risk factors of postoperative endophthalmitis in people with diabetes
title Distribution and risk factors of postoperative endophthalmitis in people with diabetes
title_full Distribution and risk factors of postoperative endophthalmitis in people with diabetes
title_fullStr Distribution and risk factors of postoperative endophthalmitis in people with diabetes
title_full_unstemmed Distribution and risk factors of postoperative endophthalmitis in people with diabetes
title_short Distribution and risk factors of postoperative endophthalmitis in people with diabetes
title_sort distribution and risk factors of postoperative endophthalmitis in people with diabetes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725099/
https://www.ncbi.nlm.nih.gov/pubmed/34708798
http://dx.doi.org/10.4103/ijo.IJO_1485_21
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